Loosing Sight

2024 was a difficult year for me. Almost exactly a year ago I was in New York working with my business partner but struggling to to see all my software bugs on the computer screen. I had a bad cold so I just assumed that was the cause of my vision problem. It got a bit better when I got home, but not completely Then one day it got much worse, and I phoned my local optometrist in a bit of a panic.  Dr Reis was trained in Brazil as an ophthalmologist and is really good, but that also means it can be very hard to get an appointment.  So I saw one of his juniors who recognized that I had edema in my cornea, prescribed a topical treatment, and booked me to see Dr. Reis as a follow up. When Dr. Reis looked at my eye he realized the source of my problem wasn't the front of the cornea, but inside on the back. He referred me to some ophthalmology specialists he knew.

I should explain that I've always had one bad eye since graduate school. In fact it was Prof Donald Mitchell who first noticed it when he was testing my vision for a research project.  My left eye has a severe case of keratoconus.  With keratoconus, the surface is irregular, and glasses can not fully correct for it.  Consequently for most of my adult life I've relied on my right eye, and, unfortunately, that was the eye that was affected.

Normally the cornea is mostly transparent, and is shaped to help focus light on the retina.  But all that depends on keeping the right amount of water in the tissue.  That is the job of a layer of endothelial cells on the the back side of the corner.  My endothelial membrane had started to fall off, allowing the  cornea to swell and to become cloudy.  It seems that I had a mild case of Fuchs dystrophy, meaning that my membrane was fragile, and probably was weakened by the cataract surgery I had the previous summer.

I used to work in the research lab in the Eyecare Centre at VGH so it was a bit strange going back there as a patient. I had a referral to see Dr. Holland, whose work I had long admired, and it was nice to see a friendly face.  However he is retiring himself, so he handled me over to a younger colleague for surgery.  Apparently my condition was sufficiently rare that Drs. Holland and Chew brought in every single medical student, resident, and fellow they could to have a look at my eye. I was a teaching case, and it was fun being useful again!

The first thing Dr Chew tried was to tack my membrane back onto my cornea using an air bubble.  I had to lie on my back for a week to keep the bubble pressing up against the cornea.  It was an enforced rest that I actually enjoyed: I spent most of my time listening to podcasts and youtube videos. However, nothing improved.  It had been a long-shot, and I was booked for transplant surgery.  In the meantime Jerena and I went off to Normandy for an extensive D-Day tour.  I could see about as well as a cat or dog, so could get around OK, but I was a hazard to anybody coming towards me from the right. Jerena took up that position to protect our fellow travelers.

By the time we got back I was down to ”count fingers” and went straight into surgery. Dr Chew did a DMEK procedure in which a new membrane is transplanted onto the back of the cornea.  That went well, and all I had to do was stay on my back for the better part of the week.  More history and geology podcasts again!

My eyesight gradually improved over the summer and we were able to go on a fantastic cruise to the north Atlantic. I get to see Dr. Chew every once in a while and we are both pleasantly pleased by how well things have progressed.  In fact Jerena wants Dr. Chew do do her cataract surgeries.   I saw Dr. Reis last month to get a new glasses as my cornea did not go back to exactly the same shape. When I saw Dr. Reis last spring my fully-corrected vision was 20/80 and now it is  20/20 (or very close).  I am extremely happy I can now see cats and dogs before they can see me.